ADVANCEMENT OF THE SCIENCE
These changes would involve training cur- rent safety inspectors and using an incremental approach to allow regulatory and industry part- ners to adapt to changing MAHC guidelines. CDC (2023b) provides resources for public healthocialsandaquaticsta toimple- ment MAHC recommendations or strengthen their aquatic health and safety programs. The advantages of incorporating MAHC guidelines would be use of the most e ective water safety inspection criteria, which could translate into reduced RWIs. Furthermore, inspection results could be compared with other jurisdictions that use similar inspection criteria. A promising aspect of our study is the ability to illustrate the distribution of swim- ming pools in Houston based on their safety grade. This mapping has potential use in injury prevention. This approach has been used in playground safety, where the safety scores of playgrounds in need of maintenance were spatially mapped in Chicago to e ect improvements in fall surfacing and equip- ment maintenance (Allen et al., 2013). The same approach could be applied to swimming pool safety in Houston. Cur- rently, Houston maintains an up-to-date list- ing of all pool violations by property that is accessible to the public (Houston Health Department, 2023b). The City of Plano, Texas, employs a similar scoring system that allows the public to look up swimming pools with color-coded scores that show the results of the swimming pool inspection (Plano Health Department, n.d.). Data from our study demonstrate that the swimming pools that failed safety inspections were predominantly concentrated in South- west Houston, which has a larger percentage of residents belonging to a lower socioeco- nomic status (City of Houston Planning & Development Department, 2016a) and racial and ethnic minority groups (City of Hous- ton Planning & Development Department, 2016b). The rate of unintentional drown- ings is higher in children belonging to racial and ethnic minorities (Felton et al., 2015; Gilchrist & Parker, 2014), which could serve as a focus for injury prevention e orts to reduce drowning. Limitations There are several limitations to our study. First, our findings are not generalizable to other jurisdictions that have other types of
Frequency of Observed Swimming Pool Violations TABLE 4 continued from page 13
Item From the Model Aquatic Health Code (MAHC) Inspection Form Observed by the City of Houston
Observed Violations # (%)
Water chemicals Approved NSF/ANSI Standard 50 DPD test kit
2 (0.05)
Proper disinfectant level pH between 7.2 and 7.8 Equipment and chemical room Automated feeder operable
516 (12.7) 449 (11.1)
99 (2.4)
Piping and valves identified and marked
238 (5.9) 126 (3.1)
Flow meter present and operating
Recirculation pump: approved, in good repair, operating
38 (0.9)
Filter: approved, in good repair, operating
8 (0.2)
Pump strainer: baskets in good condition, not clogged
1 (0.02) 74 (1.8) 1 (0.02)
Filter gauges operable: filter inlet and outlet, strainer; sight glass
Chemicals: labeled, stored safely, secured Records room Lifeguard training certification available on-site
2 (0.05)
Note. Bolded items represent critical code items in the MAHC.
FIGURE 1
Location of Swimming Pools in the City of Houston That Received A Grades
Note. Shaded area indicates the City of Houston.
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Volume 86 • Number 1
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